Tales From the Emergency Room: Dr. Amanda Miller, Paoli Hospital

For this year's Top Doctors, we turned to emergency room doctors to share their stories of adrenaline, patience and grace under fire.

By Melissa Jacobs

Pneumonia? Kidney disease? Dr. Amanda Miller ran over the options as she ran through Paoli Hospital’s emergency department. A patient who’d just arrived was in critical condition. High fever, low blood pressure, trouble breathing, lethargy, lack of appetite; the physician’s assistant listed the symptoms as they hurried to her bedside. None of it added up to anything conclusive.

The 27-year-old woman had suffered from a 103-degree fever for several days. She’d intended to ride it out, thinking she’d caught something from one of the kids in her class. That’s when Miller looked at the name on the chart and realized that she was treating her daughter’s elementary school teacher.

But there was no time for chitchat. “Her body was in severe distress,” Miller says. “This wasn’t just the flu—something was terribly wrong.” As the minutes passed, the patient deteriorated. Miller ordered an X-ray to check for pneumonia. Negative. But a urine test showed that the kidneys were compromised. An infection was overwhelming her patient’s body. “I checked her ears, nose, throat and belly, and was working my way down her body searching for clues,” Miller says.

That’s when she saw the red marks on the patient’s legs. “She said it was eczema and that it was no big deal because she’d had it for years,” says Miller.

The doctor looked closer and saw streaking—the skin around the eczema had broken. “Microbes got in through the broken skin and created an infection that spread throughout her body,” Miller says.

A blood test confirmed the diagnosis, and she placed the patient on IV antibiotics and sent her to the ICU, where she stayed for two weeks. Had the patient not gotten treatment, she would’ve gone into organ failure. But, in time, she made a complete recovery. “Not every doctor gets to save the life of her child’s teacher,” Miller says. “My daughter thought her mommy was a hero … for about a day.”